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WILKES-BARRE - The stresses of a criminal trial on corruption charges could kill former state Sen. Raphael Musto, who suffers from a debilitating liver disease and has an aneurysm that can rupture at any moment, a doctor said Monday at a hearing to determine if the ex-lawmaker is fit to stand trial.

The 84-year-old's mental health is deteriorating, too, making him unable to help his attorneys mount a defense, other doctors said.

But if the case went to a jury, Musto told another doctor, he would be found innocent.

U.S. District Judge A. Richard Caputo will decide today if the case ever gets that far. After a six-hour hearing Monday in federal court in Wilkes-Barre, Caputo said he will issue a ruling today on whether Musto is competent to stand trial on accusations he solicited and accepted bribes while a serving as a state senator.

A court-appointed expert on Monday said he is not. Dr. Susan Rushing, a Philadelphia psychiatrist appointed by Caputo in December to evaluate Musto, said the ex-senator Musto suffers from cognitive impairment which harms his ability to concentrate, remember things or fully appreciate his actions.

Rushing, of the Penn Medicine Forensic Psychiatry Services Program, said she was confident Musto's ability to help his attorneys would be "severely limited," not even taking into consideration his physical ailments.

Federal prosecutors argue they believe Musto is physically able to stand trial - even if they had to schedule court for only two hours a day to accommodate him - but acknowledged arguments made by defense doctors and Rushing were strong and "difficult points to argue against" in terms of his mental competence to stand trial.

Jack Riley, one of Musto's attorneys, renewed his argument Monday for Caputo to indefinitely delay Musto's trial, saying four out of five doctors who evaluated Musto prior to the hearing say he's unfit for trial. A fifth doctor said that liver disease alone shouldn't prevent Musto from going to trial, but didn't take into consideration other health factors, Riley said.

"This man is not physically able to stand trial," Riley said.

During a moment of clarity during his session last month with Rushing, Musto predicted how his trial would end if it was held: with a not-guilty verdict, Rushing said.

"He believed his attorneys would be able to prove his innocence on all charges," she said.

However, he told her he was "useless" to help them because he suffers from extremely fatigue that keeps him bedridden most days, she said.

Musto, of Pittston Township, did not take the witness stand Monday. He sat at a table behind his attorneys, looking forward most of the time and, at some points, dozing off. Musto walked in and out of court on his own power, not using a walker family brought with them in case he needed to use the device. The former senator declined to comment as he arrived and left the federal courthouse with his son, Ray Jr., and brother, Joseph, a former Luzerne County judge.

A federal grand jury indicted Musto shortly after his retirement in November 2010 on three counts of fraud, two counts of bribery and two counts of making false statements to investigators. The grand jury alleged that Musto, while a senator, accepted $40,000 in cash and free construction services in exchange for supporting state funding for development projects. Musto was recently hit with a superseding indictment that alleged he also solicited and accepted kickbacks from a government vendor for decades in exchange for political favors.

Musto's son testified Monday that the ex-lawmaker's quality of life has deteriorated so badly he's often bedridden. He fell several times recently, including over the weekend. Family wanted him taken to the emergency room via ambulance, he said.

"I wanted to call the ambulance, but he refused that," Musto Jr. said. "He wanted to be here today."

Family eventually called medical crews to evaluate Musto, Musto Jr. said.

Musto's trial has been repeatedly delayed for years due to his claims of deteriorating health.

His condition is irreversible, said Dr. Cataldo Doria, a liver expert and chief of transplant surgery at Philadelphia's Thomas Jefferson University Hospital who has examined Musto several times.

"There is no comeback from liver cirrhosis," Doria said.

The liver ailment contributes to Musto's extreme fatigue, dizziness, loss of cognitive ability, and intense scratching that leaves Musto with sores over his body that bleed, said Doria. He also has an aortic aneurysm that could rupture if put in a stressful situation like a trial, the doctor said.

"Mr. Musto would die," Doria said.

Doria said it was clear to him that Musto's health is worsening after a recent examination.

"He was more confused. He was less aware of his surroundings. He was much slower in his speech. At times, he was not focusing on our conversation," Doria said.

Federal prosecutors said it appears some of Musto's measurable health issues have stabilized. Dr. K. Rajender Reddy, a court-appointed liver expert from the University of Pennsylvania, was the lone expert to deliver positive news for prosecutors on Monday. Reddy said Musto's liver disease was under control and has a 90 percent chance of living at least two more years. He thought Musto could proceed to trial.

When asked about his health during a recent interview in his home with The Citizens' Voice, Musto said if he claims he's healthy he's "going to get a headline that I'm well enough to go to trial."

"If I tell you I'm not feeling well, the byline is going to be, 'He's putting a front on, that he's pretending he's sick,'" Musto said.

bkalinowski@citizensvoice.com 570-821-2055, @cvbobkal

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